Lebanon News

Hospital says refugees giving birth prematurely

Premature babies of Syrian mothers occupy three of the 15 incubators at Taanayel Hospital in the Bekaa. (The Daily Star/Hasan Shaaban)

TAANAYEL, Lebanon: Crossing the Bekaa border in January, a Syrian man spotted a mother cradling a newborn baby girl, who was sick, her skin turning blue.

Having delivered with an under-qualified midwife in Lebanon, the mother was attempting to return to Damascus, where health care was free. In a gesture of humanity, the man took the woman to Taanayel Hospital in the Bekaa.

Hospital manager Shady Bader recounts the incident.

“She had not received the necessary after care so the mother was taking her back to Damascus. But the man, luckily, brought her here. And he paid for everything,” he says.

For expectant mothers without such generous compatriots, however, treatment costs at the hospital are covered by local and international NGOs.

The neonatal intensive care unit at Taanayel Hospital has seen an increase in patients over recent months, as expectant mothers cross into Lebanon from Syria, some going into labor prematurely, or miscarrying in the early stages of pregnancy.

This tiny private hospital, with 15 incubators, 15 maternity beds and 10 pediatric beds, is one of the largest dedicated maternity units in the Bekaa, and since the uprising next door has grown increasingly violent and protracted, local and international charities are helping to cover the costs of treatment here, with gaps sometimes filled by philanthropic individuals.

Originally Medecins Sans Frontieres and the Lebanese Islamic relief charity, Azhar Foundation, were covering the costs of treatment in cash payments, Bader says.

In April the hospital signed a contract with the International Medical Corps, which now covers 85 percent of the treatment costs.

The remainder of costs are paid for by Azhar and the Hariri Foundation, both of which also help patients obtain secondary medical assistance after leaving Taanayel.

In recent months, around 30 percent of the hospital’s some 250 patients per month are Syrian refugees, Bader says. The hospital provides care for women and children, although a special exception was made a couple of months ago when a man shot in Syria was transferred across the border.

Of the 15 incubators, seven are currently occupied, and three of those are the babies of Syrian refugees. The majority of refugee mothers at the hospital have gone into labor early, Bader says. Some are giving birth at around six or seven months, to babies weighing as little as 1 kilogram (the average weight for a full-term newborn is over 3 kilos). Others have lost their babies much earlier in the pregnancy.

Environmental factors such as the mother’s nutrition and lack of neo-natal care are possible causes, as are the undeniable stresses of escaping from a war zone.

“Stress leads to premature births. Also, I don’t know what sort of conditions these women are living in, or where they are living.

“Before arriving here, they have not been under observation from any gynecologists or midwives. And they often have no money: these are all big problems,” explains Dr. Zahra Haidar, a pediatrician at both the Taanayel and Chtoura hospitals in the Bekaa.

A nurse at the hospital, Saria Nasrallah, agrees that “stress and the situation in Syria” are contributing to this higher incidence of premature births. Some refugee women have reported bleeding while en route to Lebanon, as the tense journey put their bodies through extra strain.

The premature births usually require delivery by caesarean section, says Joe Jabbour, senior health officer for the IMC in Lebanon.

“As they haven’t been for follow ups during their pregnancies,” he says, and due to the fact that, “once they go in to labor the doctor here knows nothing about the baby or its conditions,” so a natural birth would prove even riskier.

Babies born at six or seven months spend somewhere between two weeks to more than a month in the neonatal intensive unit, which is extremely expensive, costing $250 per night for each baby, Jabbour adds.

In order to be eligible for treatment paid for by the IMC, refugees must first register with the U.N. High Commissioner for Refugees, which has mobile units traveling around the Bekaa.

In emergency cases, or if there is no UNHCR unit in the area, families can be treated first and register later.

But many are hesitant to register at all, fearing their personal information may get into the wrong hands and lead to retribution against relatives still living in Syria.

In these situations, local Lebanese philanthropists often come forward to cover the cost of treatment for Syrian refugees at the hospital, says Rima Bader, in charge of hospital accounts.

One family now at the hospital tell of another form of generosity.

After paying to have themselves smuggled across the border just over a month ago, they arrived to the Bekaa and asked around for cheap accommodation. A Qatari man, who owns a house in the region, offered to let the family of four stay in the residence for as long as they need it, in exchange for the father carrying out the maintenance and gardening work.

Refusing to give their names, or be photographed, the family, who are from Aleppo, brought their one-and-a-half-year-old daughter to the hospital after she was suffering from a high temperature and diarrhea.

Unable to afford treatment at the first hospital they visited, they were referred to Taanayel. The baby is now on an IV drip.

Haidar says aside from premature births, the most common ailments among the refugee children have been gastroenteritis, and a couple of cases of meningitis.

Except for the man who had been shot in the leg, no other wounded patients have arrived at the hospital.

Rima, from Kunban in Damascus, is at the hospital with her 3-year-old daughter Maram, who had a high fever and went into shock.

She crossed at the Masnaa crossing a week ago, with her mother, her siblings and her three children.

Her family is staying with relatives in Majdal Anjar.

Rima was referred to the hospital after registering with UNHCR, but says she has received no other aid. After Kunban was bombed, the family moved elsewhere in the capital, but then, still feeling unsafe, fled to Lebanon.

“I wish I could go back, but my husband tells us not to.

“He wants us to be safe here, and he says he can join us if things get worse,” Rima says.

 
A version of this article appeared in the print edition of The Daily Star on August 09, 2012, on page 4.

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